The plot follows Agnes White, a lonely waitress grieving her missing son and fleeing an abusive ex, who enters a relationship with Gulf War veteran Peter Evans; together they spiral into folie à deux involving imaginary government-implanted bugs, self-mutilation, and a fiery climax. All core elements derive from traditional dramatic and horror conventions around mental illness and isolation, with no embedding of contemporary social justice themes, identity politics, or critiques of systemic norms. Casting relies on established performers including Ashley Judd as Agnes, Michael Shannon as Peter, and Harry Connick Jr. as Jerry Goss, drawn directly from the source play without any race- or gender-swapping or DEI-driven additions.

Themes stay limited to paranoia, substance abuse, PTSD, and delusional parasitosis viewed through personal trauma and folie à deux, avoiding activist framing or identity-based conflicts. Creator Tracy Letts, adapting his own play, centers the story on the spread of conspiracy thinking in the post-Oklahoma City bombing era, keeping the work apolitical in the modern progressive sense and free of inclusion mandates or norm-challenging elements, which preserves its focus on raw psychological horror.